Selective association of electrocardiographic abnormalities with insulin sensitivity and beta-cell function in type 2 diabetes mellitus: a cross-sectional analysis

Anish B. Bhatt, Claire K. Mulvey, Atif N. Qasim, Jayamohan V. Nair, Michael R. Rickels, Stuart B. Prenner, Nayyar Iqbal, Muredach P. Reilly

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: We investigated the association of electrocardiographic (ECG) abnormalities with markers of insulin resistance and pancreatic beta-cell dysfunction in a cross-sectional study of type 2 diabetes patients. Methods: Electrocardiographic criteria were evaluated in the Penn Diabetes Heart Study participants (n = 1671; 64% male; 61% Caucasian), including a sub-sample (n = 710) that underwent oral glucose tolerance testing. The Matsuda Insulin Sensitivity Index and homeostasis model assessment of insulin resistance (HOMA-IR) estimated insulin sensitivity; Insulinogenic Index and homeostasis model assessment of beta-cell function assessed beta-cell function. Multivariable regression modelling was used to analyse associations of ECG changes with these indices. Results: In unadjusted analyses, subjects in the highest quartile of Matsuda index had the lowest prevalence of Q-waves (6.3% versus 15.3%, p = 0.005). In adjusted models, an inverse association was seen between Q-waves and log Matsuda index [one standard deviation increase; OR = 0.59 (95% CI 0.43-0.87 p = 0.001)]. In the full Penn Diabetes Heart Study, there was a direct association between Q-waves and HOMA-IR [one standard deviation increase; OR = 1.43 (95% CI 1.13–1.81, p = 0.003)]. In adjusted models, left ventricular hypertrophy also was inversely associated with Matsuda index and directly with HOMA-IR. Higher Insulinogenic Index scores were associated with a lower prevalence of nonspecific ST changes [OR = 0.78 (95% CI 0.62–0.98, p = 0.032)]. Conclusions: In type 2 diabetic patients, both oral glucose tolerance testing-derived and HOMA-derived measures of insulin resistance were associated with pathologic Q-waves and left ventricular hypertrophy on ECGs.

Original languageEnglish (US)
Pages (from-to)736-744
Number of pages9
JournalDiabetes/Metabolism Research and Reviews
Volume32
Issue number7
DOIs
StatePublished - Oct 1 2016

Fingerprint

Type 2 Diabetes Mellitus
Insulin Resistance
Cross-Sectional Studies
Homeostasis
Left Ventricular Hypertrophy
Glucose Tolerance Test
Insulin-Secreting Cells
Electrocardiography

Keywords

  • beta-cell function
  • ECG
  • insulin sensitivity
  • MISI (Matsuda Insulin Sensitivity Index)

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Selective association of electrocardiographic abnormalities with insulin sensitivity and beta-cell function in type 2 diabetes mellitus : a cross-sectional analysis. / Bhatt, Anish B.; Mulvey, Claire K.; Qasim, Atif N.; Nair, Jayamohan V.; Rickels, Michael R.; Prenner, Stuart B.; Iqbal, Nayyar; Reilly, Muredach P.

In: Diabetes/Metabolism Research and Reviews, Vol. 32, No. 7, 01.10.2016, p. 736-744.

Research output: Contribution to journalArticle

Bhatt, Anish B. ; Mulvey, Claire K. ; Qasim, Atif N. ; Nair, Jayamohan V. ; Rickels, Michael R. ; Prenner, Stuart B. ; Iqbal, Nayyar ; Reilly, Muredach P. / Selective association of electrocardiographic abnormalities with insulin sensitivity and beta-cell function in type 2 diabetes mellitus : a cross-sectional analysis. In: Diabetes/Metabolism Research and Reviews. 2016 ; Vol. 32, No. 7. pp. 736-744.
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T1 - Selective association of electrocardiographic abnormalities with insulin sensitivity and beta-cell function in type 2 diabetes mellitus

T2 - a cross-sectional analysis

AU - Bhatt, Anish B.

AU - Mulvey, Claire K.

AU - Qasim, Atif N.

AU - Nair, Jayamohan V.

AU - Rickels, Michael R.

AU - Prenner, Stuart B.

AU - Iqbal, Nayyar

AU - Reilly, Muredach P.

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AB - Background: We investigated the association of electrocardiographic (ECG) abnormalities with markers of insulin resistance and pancreatic beta-cell dysfunction in a cross-sectional study of type 2 diabetes patients. Methods: Electrocardiographic criteria were evaluated in the Penn Diabetes Heart Study participants (n = 1671; 64% male; 61% Caucasian), including a sub-sample (n = 710) that underwent oral glucose tolerance testing. The Matsuda Insulin Sensitivity Index and homeostasis model assessment of insulin resistance (HOMA-IR) estimated insulin sensitivity; Insulinogenic Index and homeostasis model assessment of beta-cell function assessed beta-cell function. Multivariable regression modelling was used to analyse associations of ECG changes with these indices. Results: In unadjusted analyses, subjects in the highest quartile of Matsuda index had the lowest prevalence of Q-waves (6.3% versus 15.3%, p = 0.005). In adjusted models, an inverse association was seen between Q-waves and log Matsuda index [one standard deviation increase; OR = 0.59 (95% CI 0.43-0.87 p = 0.001)]. In the full Penn Diabetes Heart Study, there was a direct association between Q-waves and HOMA-IR [one standard deviation increase; OR = 1.43 (95% CI 1.13–1.81, p = 0.003)]. In adjusted models, left ventricular hypertrophy also was inversely associated with Matsuda index and directly with HOMA-IR. Higher Insulinogenic Index scores were associated with a lower prevalence of nonspecific ST changes [OR = 0.78 (95% CI 0.62–0.98, p = 0.032)]. Conclusions: In type 2 diabetic patients, both oral glucose tolerance testing-derived and HOMA-derived measures of insulin resistance were associated with pathologic Q-waves and left ventricular hypertrophy on ECGs.

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KW - insulin sensitivity

KW - MISI (Matsuda Insulin Sensitivity Index)

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